| Summit Physical Therapy | |
|
152 N Seneca Springs Way # 110, Star, ID 83669-6037 | |
| (208) 995-2913 | |
| (208) 995-2659 |
| Full Name | Summit Physical Therapy |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 152 N Seneca Springs Way # 110, Star, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871331702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Secondary |
| Provider Name | Randall K Langley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598852139 PECOS PAC ID: 9436139466 Enrollment ID: I20101011000441 |
| Provider Name | Ian David Tracy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134643885 PECOS PAC ID: 3173898368 Enrollment ID: I20171016000650 |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Physical Therapy 457 S Fitness Pl Ste 100, Eagle, ID 83616-6568 Ph: () - | Summit Physical Therapy 152 N Seneca Springs Way # 110, Star, ID 83669-6037 Ph: (208) 995-2913 |
Mrs. Danielle-noelle D. Wuerfel, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11095 W Collina Vista Dr, Star, ID 83669 Phone: 269-277-1224 | |
Nichols Therapy Group Pc Physical Therapist Medicare: Medicare Enrolled Practice Location: 9652 W State Street, Star, ID 83669 Phone: 208-286-0766 Fax: 208-286-0768 | |
Krysia Kristine Rousseau, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 704 N Nebula Ct, Star, ID 83669 Phone: 208-703-9824 | |
Sydnie Alexandra Keller, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 152 N Seneca Springs Way, Star, ID 83669 Phone: 208-995-2913 | |
Mrs. Judianne King Nichols, MPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 9652 W State Street, Star, ID 83669 Phone: 208-286-0766 Fax: 208-286-0768 | |
Lindsey E. Decloss, M.S.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9652 W State St, Star, ID 83669 Phone: 208-286-0766 | |
Clayton Towner Shaw, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 64 S Star Rd, Star, ID 83669 Phone: 208-268-0089 Fax: 208-488-4248 |